Safety and effectiveness of direct-acting antiviral drugs in the treatment of hepatitis C in patients with inflammatory bowel disease

BACKGROUND AND AIMS

Hepatitis C virus (HCV) management in Inflammatory Bowel Disease (IBD) is uncertain. The ECCO guidelines 2021 recommended HCV treatment but warn about the risk of IBD reactivation. We aimed to evaluate 1) the effectiveness and safety of direct-acting antivirals (DAAs) in IBD; 2) the interaction of DAAs with IBD drugs.

METHODS

Multicentre study of IBD patients and HCV treated with DAAs. Variables related to liver diseases and IBD, as well as adverse events (AEs) and drug interactions, were recorded. McNemar's test was used to assess differences in the proportion of active IBD during the study period.

RESULTS

We included 79 patients with IBD and HCV treated with DAAs from 25,998 IBD patients of the ENEIDA registry. Thirty-one (39.2 %) received immunomodulators/biologics. There were no significant differences in the percentage of active IBD at the beginning (n = 11, 13.9 %) or at the 12-week follow-up after DAAs (n = 15, 19 %) (p = 0.424). Sustained viral response occurred in 96.2 % (n = 76). A total of 8 (10.1 %) AEs occurred and these were unrelated to activity, type of IBD, liver fibrosis, immunosuppressants/biologics, and DAAs.

CONCLUSIONS

We demonstrate a high efficacy and safety of DAAs in patients with IBD and HCV irrespective of activity and treatment of IBD.

A study of the discomfort associated with tennis shoes

Subjective tests based on information gathered using 'discomfort questionnaires' have been used widely in ergonomics. In this study, we used a similar method to examine the discomfort associated with the footwear worn in tennis matches. A sample of 146 tennis players from a population of approximately 4000 completed the questionnaire. We performed a descriptive analysis of the study variables. The associations between discomfort and pain and between discomfort and design errors were evaluated using cross-tabulation and chi-squared tests. We found that 9% of players considered their footwear to be uncomfortable, 23% considered it to be acceptable and 68% regarded it as comfortable. Six design errors were identified and five body areas were reported as experiencing discomfort due to the footwear. Factor analysis identified four factors related to discomfort and six design errors. Subsequent correlation analysis identified several relationships among these factors. There was a strong correlation (r = 0.187, P = 0.022) between plantar discomfort and incorrect arch support.

Idiopathic chondrolysis of the hip: long-term evolution

Idiopathic chondrolysis of the hip is characterized by the destruction of the articular cartilage due to an unknown cause, principally affecting women during adolescence and producing premature degeneration of the hip. Twelve cases (11 patients) were reviewed at our hospital, with an average follow-up period of 13.2 years, during which a clinical and radiologic study was performed. Despite the treatment implemented, idiopathic chondrolysis of the hip causes progressive degeneration of the joint with the appearance of almost constant pain, stiffness, and anomalous positions. Radiologic studies show concentric narrowing of the articular space, decrease in the width of the femoral head and neck, and shortening of the affected member due to alteration in the growth physis of the upper extremity of the femur.

Properties of shoe insert materials related to shock wave transmission during gait

The influence of the mechanical characteristics of certain insole materials in the generation and transmission of heel strike impacts while walking was studied. Three insole materials were selected according to their mechanical characteristics under heel strike impacts. The selection of materials has made it possible to distinguish the effect of rigidity and loss tangent in the transmission of heel strike impacts. A lower rigidity and a high loss tangent have been shown to reduce the transmission of impacts to the tibia. A low rigidity was seen to significantly increase the transmission of impacts from tibia to forehead.

Dynamic study of insole materials simulating real loads

A new methodology of biomechanical analysis of materials for shoe inserts is presented. This methodology is based on the determination of the loads applied to the materials in real situations and its simulation by means of a dynamic testing machine. Both the rigidity and the energy-absorbing characteristics of the materials are investigated as a function of frequency. This methodology is applied to the study of several commercially available viscoelastic materials intended for shoe inserts in the treatment and prevention of degenerative joint diseases. The influence of thickness is investigated as well as the frequency-dependent behavior of the materials studied. Significant differences between materials and different behavior as a function of thickness and frequency were found. Poron materials were found to have the lowest rigidity, good for adequate pressure distribution, while Noene showed the highest energy absorption. A careful selection of the thickness of Sorbothane was found to be necessary for avoiding flattening of the material.